A descriptive epidemiological review of hospital admissions for UTI from long term care facilities and a systematic review of strategies to reduce the risk of catheter associated UTI in long term care facilities in order to reduce these admissions.

Abstract

Urinary tract infection (UTI) is a significant source of morbidity and mortality in the elderly. Urinary catheter use greatly increases the risk of contracting a UTI. Use of a urinary catheter has been shown to increase the risk of contracting a UTI-accounting for up to 40% of nosocomial infections in one (older) study. A number of studies and reviews of studies have been done to assess strategies for reducing the risk of such catheter associated UTI (CA-UTI) in the acute setting. However, there has been less work done in long term care facilities (LCTF), a setting where UTI incidence is already high and urinary catheter use is increasing. LTCF have a number of issues that increase the difficulty in applying strategies developed for more acute care settings, including higher percentage of comorbid conditions and reduced staffing and funding. This Capstone project has two aims. It will first examine the Texas Health Care Information Collection (THCIC) database to find the number and attributes of hospital admissions from LTCF for UTI in order to describe the epidemiology of the problem. Second, it aims to do a systematic review of the literature and assess strategies for reducing risk of CA-UTI in LTCF, especially in terms of feasibility and economic impact. The author will be initially using the PubMed database and concentrating on English language articles. Keywords include Long-Term-Care-Facility, UTI, and Urinary Catheter. Expansion into other databases will be done as needed.